When your Adolescent has Generalized Anxiety Disorder

There are several types of Anxiety Disorders like Post Traumatic Stress Disorder, Social Anxiety, Panic Disorder, Obsessive Compulsive Disorder, and Generalized Anxiety Disorder (GAD). Adolescents can experience these disorders in combination or have just one of these. We are mainly concerned with Generalized Anxiety Disorder here. Currently teenagers are facing so many worries, tension regarding grades, pimples, gangs, drugs and alcohol, war and terrorism. A little worry is normal and realistic. However, when the worry continues to occupy a teen’s mind, there is a problem. Sometimes, teens have exaggerated worry and tension which are out of proportion to the situation. Teens with GAD worry about all kinds of things expect the worst in every situation and tend to worry about things like school work, future, performance in a wide range of situations. The condition might last for months or even years. Once this becomes like a regular pattern, it can adversely affect the teen’s mental health and physical health.

Typical symptoms of GAD are, restlessness, trouble concentrating, poor sleep, nonstop tension, inability to relax, racing thoughts which are troubling in nature. Teens might worry about big things and little things and tend to engage in incessant fretting that always remain the same. GAD affects both mind and body. Young people might complain of headaches, pains, upset stomach, irritable bowel syndrome, and ulcers. Their breathing is shallow and they appear fidgety. They might tap their feet, show unusual tics on the face, and generally appear restless and impatient. They also appear preoccupied with their schedule, finances, and health. They sometimes appear to be perfectionist also. They will redo their assignment until everything looks perfect and according to their standards. The self imposed pressure may lead to blow ups, especially when there are unexpected changes in plans. Parents might view their teen as the perfect child but in reality there is a lot of turmoil underlying the punctual and organized façade. A stressful event can set off a new round of worrying and causes symptoms to get worse.

A number of other conditions could coexist with GAD as well. Teens with GAD are at high risk of developing depression. Both GAD and depression manifest the same symptoms, agitation, trouble concentrating, irritability, insomnia, and restlessness. Research shows that the symptoms of GAD get worse when the teen is faced by a stressful situation. Some studies show that the GAD might run in the family. Also, brain structure and chemistry can play a significant role too. Some studies show that teens with GAD tend to have an enlarged amygdale which controls the fear response. Brain imaging studies have demonstrated that there is an increased activity in the cerebral cortex and decreased activity in the basal ganglia. These findings suggest that the brains of people with GAD are primed to overreact to stress. People with GAD also seem to have low levels of GABA and serotonin. GABA appears to reduce anxiety and serotonin helps regulate mood and sleep. Deficiency of serotonin leads to anxiety disorders and depression. The anti anxiety and antidepressant medications help increase the levels of serotonin and GABA.

GAD also has a genetic component. It needs to be addressed professionally and with care otherwise it can cause significant suffering and hardship. The illness can adversely impact on the teens’ relationships with significant others, friends, children and coworkers. Early intervention can save the teen from endless hours of worry. Parents need to empower them and reassure them so that they can become more productive and live a happy life. The first step is to find out for sure what you are dealing with. Since GAD often manifests itself in physical symptoms, parents want to begin by making an appointment with their teen’s internist. The chronic and gradual nature of GAD makes it harder to recognize than a disorder that leads to a sudden dramatic shift in behavior or personality. An appointment with a mental health professional is also important. Proper treatment might remedy complications such as refusal to go to school or abusing alcohol or other drugs.

COGNITIVE- BEHAVIORAL TREATMENT:

This is the best type of treatment to help your teen address the symptoms of GAD. The CBT focuses on changing maladaptive or distorted thinking. Teens with GAD tend to see even minor setbacks as major catastrophes. They tend to magnify little events and their perception has distortions like overgeneralizations, mind filter, magnification of the negative and minimization of positive aspects of the situation, White or black thinking, Perfectionism,  saying” My Fault”, personalization, and jumping to conclusion. Therapists tend to make them aware of their distortions and give them a realistic perspective of the situation so that they can rectify their misconstrued perceptions of the event and situation. Therapist challenges their distorted thinking by asking them to jot their thoughts down, identify the distortion, and come up with a counterstatement that challenges the distorted view. They are asked to rate the intensity of their emotions on a scale of 1-10 and asked to compare the ratings before they made the counterstatements and after they made the rational counterstatements. Once the teens learn the pattern, they become more cognizant of their distortions and become willing to see them, challenge them and replace them with rational counterstatements. For example, a bad grade in Science might make most students feel slightly disappointed and discouraged. However, for a student with GAD, it might lead to self berating statements like “I am stupid”, “I am a failure”. Distorted thoughts can lead to counterproductive behaviors. As a result, the teens may fret so much over every detail of an assignment that they never manage to complete it. Or they find excuses to stay home from school- not due to fear of what others might think of them, but out of concern that they won’t meet their overly perfectionist standards. The CBT therapist tries to break this destructive chain of thoughts and behaviors. They give them the realistic view of the situation and offer counterstatements like, “ I am not stupid”, I am not a failure “One bad grade is not the end of the world”.

The Behavioral Component of CBT also plays a role in treatment. The therapist might teach the teen how to relax muscle groups, give relaxation training, breathing exercises, and visualization with guided imagery. The teen is also empowered with rational problem solving solutions to address worrisome situations. Since CBT implies that thought, behavior, and feelings are interconnected, it is important to change your thoughts which create negative feelings and this will eventually change the behavior and attitude.

Systematic Desensitization

It is a particular type of therapy in which the teen is systematically exposed to the situations that make them anxious. The idea behind this type of therapy is that it is best to confront the fears directly. This technique is best utilized when treating panic disorder or specific phobias.  The therapist makes the hierarchy of situations and asks the teen to imagine him or herself in the scene and face the situation gradually as the steps become increasingly harder. They are suggested to relax and then given the next step in the hierarchy ranging from least to most anxiety provoking. This way the teen learns to associate positive feelings of relaxation with the hierarchy steps of anxiety provoking situations. Since anxiety is developed with the conditioning process, the association is broken and the teen learns to unlearn the behavior. In exposure therapy, patients rank their fears and worries in a hierarchy based on how frightening the things are.

Medication:

Pharmacotherapy is also offered if the GAD has caused dysfunction in the person’s life. The SSRIs are widely used to treat anxiety disorders. They increase the supply of serotonin, a neurotransmitter that plays a central role in anxiety disorders. Medications such as Lexapro, Paxil, Prozac, Zoloft are prescribed to treat the condition.

SNRIs are also popular in treating anxiety disorders. Antidepressants called Cymbalta and Effexor act on serotonin much like SSRIs. It takes about few weeks to kick in the effects of the medication. The side effects are similar to those of SSRIs, and the FDA warning about the risk of suicidal thoughts and behaviors applies too. Some times Tricyclic antidepressants’ and Benzodiazepines are also prescribed to help the condition.

Support Your Teen

As parents, you can offer as much support as you can to help the teen. When they get ongoing support from the family members, they feel more reassured and it helps ease their tension level too. It is important to navigate the ups and downs of the GAD. By reading the available literature, you might be able to educate yourself and provide the necessary support to your teen. It is not a good idea to feed in to the anxiety of your teen by you worrying about it. You might inadvertently fuel their anxiety by doing so. You do not want to model the anxious behavior and give a wrong message. Refrain from being overprotective and rescuing your teen from facing challenging situations. You might deprive them from the chance to confront and overcome their fears. By allowing them to face their anxious situations and withholding the need to help, you will be helping your teen to regain confidence and foster independence.

Schedule a Worry Time:

This is a behavioral technique that helps the teen deal with intrusive worries. When you ask them to schedule a 15 minute worry time, twice a day. Tell them to entertain worry thoughts only at these specified times. If worries pop up other times, tell them to have them wait until the scheduled time arrives. During the worry time, they can think about all their problems, fret over them, and feel tensed. They might find that it will be hard to sustain this for a full 15 minute period. Sometimes, it is also a good idea to imagine that you packed your worries in a shoe box and do not open it until the next scheduled worry time. By doing this, you are training your mind to worry only on scheduled times versus having worry thoughts all day long and spoiling your mood.

As parents, it is important to remember that stress is an unavoidable part of life so you cannot really shield your child from it. It is your job to help them learn coping mechanisms to deal with their stress. Tell them to relax their bodies and mind. Talk to them and spend time with them. Help your teen understand that their excessive worries are counterproductive and offer them viable solutions to their problems. Give them an optimistic outlook and encourage seeing the silver linings in clouds until the anxiety is subsided. Encourage them to go for walks with you and open up interesting conversations. Teach them that it is okay to be human, make mistakes and learn from them. Give them positive feedback for their good efforts and reinforce them with praise for their success and efforts.

GAD is a long term condition that may get better for a while and then gets worse when the person is faced with stressful situations. Treatment can greatly reduce the suffering and free up wasted energy.
Hypnosis can also help reduce symptoms of anxiety disorders in adolescents and adults.

Please visit our Blossom Hypnotherapy page to learn how hypnosis can help reduce symptoms of Anxiety disorders.

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